A follower writes in with a very common question for Tom:
Is there a connection between the fascia and inguinal hernia? (I have had a hernia inguinalis since 2014). If so, what chances of recovery / treatment options exist without surgery? And where?
Yes – an inguinal hernia is a pathological overstretching of the abdominal fascia in the spot where there is a natural opening in men through the three layers of abdominal muscle. It can happen through overstraining – in lifting things or constipation, e.g. There are some inherited dispositions toward hernias, it seems.
It can be exacerbated by postures that increase standing abdominal pressure.
The chances of natural recovery through movement and manual therapy varies with a) how long it has been around, and b) how severe it is.
a) 4 years is fairly long for the pocket to establish itself in the plastic fabric of the fascia – earlier treatment lends better and more lasting results. That said, try manual and movement therapy before surgery because it is less invasive. Seek a competent therapist specially skilled in managing hernias – could be a physiotherapist, osteopath, Rolfer, or visceral manipulator – experience is more important than method. It will probably involve some rethinking of your posture and retooling of your movement.
b) If there is little pain and only a mild bulge to be felt above and laterally to the pubic bone, this is within the healable realm. If there is a loop of small intestine in your scrotum, surgery is probably the best road up.
The surgery is not that bad if the hernia is that bad, and they either simply sew it up, or more often these days insert a mesh to substitute for the original fascial wall. The mesh can create scar tissue in some, and is more easily accepted by others.
Pre-habilitation and rehabilitation, as I outlined above, with a skilled manual therapist will produce better results for the surgery if necessary.